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Epidemiology and Outcomes of Clostridium difficile Infection in Allogeneic Hematopoietic Cell and Lung Transplant Recipients
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March 06 2018
Source: Transpl Infect Dis. 20(2):e12855 -
Alternative Title:Transpl Infect Dis
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Description:Background.
Clostridium difficile infection (CDI) is a common complication of lung and allogeneic hematopoietic cell (HCT) transplant, but the epidemiology and outcomes of CDI after transplant are poorly described.
Methods.
We performed a prospective, multicenter study of CDI within 365 days post-allogeneic HCT or lung transplantation. Data were collected via patient interviews and medical chart review. Participants were followed weekly in the 12 weeks post-transplant and while hospitalized and contacted monthly up to 18 months post-transplantation.
Results.
Six sites participated in the study with 614 total participants; 4 enrolled allogeneic HCT (385 participants) and 5 enrolled lung transplant recipients (229 participants). 150 CDI cases occurred within one year of transplantation; the incidence among lung transplant recipients was 13.1% and among allogeneic HCTs was 31.2%. Median time to CDI was significantly shorter among allogeneic HCT than lung transplant recipients (27 days vs. 90 days; p=0.037). CDI was associated with significantly higher mortality from 31–180 days post-index date among the allogeneic HCT recipients (Hazard ratio [HR]=1.80; p=0.007). There was a trend towards increased mortality among lung transplant recipients from 120–180 days post-index date (HR=4.7, p=0.09).
Conclusions.
The epidemiology and outcomes of CDI vary by transplant population; surveillance for CDI should continue beyond the immediate post-transplant period.
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Pubmed ID:29427356
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Pubmed Central ID:PMC6065107
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